best adult female acne treatment in Singapore

Hormonal Acne Treatment

Get control of your hormonal acne with clinically proven treatments.

Targeted and customised treatment for female pattern acne on the lower face and body.

hormonal acne on jawline
Adult female hormonal acne on jawline and neck. Note keloid scarring.

Table of Contents

What is Hormonal Acne?

Although acne is most common during the adolescent period, it can affect all age groups. Some studies have shown that prevalence of acne in adult women from 20 to 29 years and 30 to 39 years, is about 50% and 35% respectively.

It is believed that a combination of genetic and hormonal factors contribute to the development of adult female hormonal acne. In addition, other factors such as diet, stress and certain endocrine disorders may contribute to the condition.

While this condition can be chronic and last for many years, it is also a treatable condition. Undoubtedly, maintenance treatment is essential to minimize relapse and the psychological burden of the condition.



As a clinician with more than 15 years of experience, Dr Ng. understands the impact of how acne can affect an individual. Acne knows no boundaries, afflicting a wide range of age groups and affecting both genders for varying lengths of time. Dr. Ng provides a patient-centric approach that is backed by the latest scientific evidence as well as his own wealth of experience to create a care plan for the best acne treatment that is unique to your skin type. Early intervention can help prevent acne scars, restore your skin and confidence.

Acne vulgaris in adult women, may persists from the teenage years or occur as adult-onset acne. In the latter case, women often feel upset and puzzled by the onset and persistence of acne later on in life. Hormonal acne treatment and management for adult women must taken into account lifestyle factors, family planning and underlying causes of androgen excess.

What Does Hormonal Acne Look Like?

Hormonal Influences On Cystic Acne: Unravelling The Connection

In contrast to teenage acne, adult female acne has a wide range of clinical skin appearance. They range from inflammatory acne vulgaris to blackheads and whiteheads, and even cystic acne. Often enough, there is a mixture of acne spots, and may affect the face, jawline, and back areas. In females, a U-shaped pattern that affects the sides of the face, jawline and chin is typical of adult hormonal acne.

However, every individual’s acne condition is unique. You may notice acne on other areas such as the chest, shoulders, back and other areas of the face.

Furthermore, Acne scarring is also common in adult onset acne. In addition, higher rates of post-inflammatory hyperpigmentation and keloids are reported. Consequently, this further exacerbates the psychological impact the condition has on women. Higher rates of depression, anxiety and stress have been reported. 

Hormonal Acne
Acne Vulgaris
Lower face, jaw, chin and neck
Forehead, nose, cheeks, back and chest
Mestruation, Pregnancy, Puberty
Diet, Stress, Certain skin care products
Adult hormonal acne can last many years
Some cases can persist into adulthood
Polycystic ovarian syndrome (PCOS)
Genetics, Inflammation, Sebum production
Scarring Potential
Significant if cysts/nodules develop
Significant if cysts/nodules develop

What Triggers Hormonal Acne?

  1. Acne may flare up before, during and after menses.
  2. Inappropriate use of skin care products e.g. comedogenic (blackheads & whiteheads forming), acnegenic (acne forming) and oil based skin care products.
  3. Dietary factors. Although there is no firm evidence, some individuals find that food rich in sugar and dairy products may worsen their acne.
  4. Certain medical conditions such as Polycystic Ovarian Syndrome.

What can lead to Androgen excess?

The vast majority of women with adult onset acne do not have increased levels of the hormone, androgen in their blood streams. 

The most common cause of acne that is driven by an excess of androgen is a condition known as Poly-Cystic Ovarian Syndrome (PCOS). In PCOS, women may notice excess facial hair, irregular menses and a sudden onset of severe acne. 

Women with PCOS may also notice scalp hair loss, hyper pigmentation of the skin, increased libido and obesity. The acne may not be treatable with standard medical therapies. Further evaluation with a blood test, and/or ultrasound scan may be needed to help diagnose the condition. 

women with healthy looking skin
Hormonal acne can affect women in their 20s to 40s

Diagnostic evaluation

Accurate diagnosis involves a thorough medical history and physical examination. Laboratory tests to evaluate hormone levels, particularly androgens, may be indicated in cases where endocrine disorders are suspected. An assessment of the patient’s menstrual history, signs of hyperandrogenism (such as hirsutism), and any underlying medical conditions is crucial.

Hormonal acne Treatment Options:

Hormonal acne treatments in adult women are well established. A treatment program must taken into account age, lifestyle factors, family planning and existence of underlying medical conditions.

For mild cases, topical prescription acne creams are suitable. Although there is a wide range to choose from, your doctor will guide you to the best choice.

For moderate to severe cases, an oral antibiotic is often added to the program to bring the inflammatory component of acne under control. However, there is an emerging trend of antibiotic-resistant acne worldwide.

In severe or resistant cases of acne,  oral isotretinoin is a well established treatment option. Oral isotretinoin effectively shrinks down the oil glands, and clears up whiteheads and inflammation associated with acne. This is strictly not suitable if you are planning for a family or are pregnant.

Hormonal acne treatment works by decreasing the amount on androgens and testosterone in your blood stream. Anti-androgen medications and oral contraceptive medications may be prescribed in women with adult onset acne. Low dose Spironolactonea diuretic with an anti-androgen effect, has shown to be safe and effective for hormonal acne in women. Possible side effects of spironolactone may include dizziness, diarrhoea, breast pain, dry mouth and irregular periods.

Importantly, there are certain medications, both oral and topical that are unsafe during pregnancy. These include some oral antibiotics, topical and oral retinoids, and hormonal treatments. Acne during pregnancy is a treatable condition, where safe and effective options are available. 

Topical hormonal acne treatment

Benzoyl peroxide is a common ingredient found in many over-the-counter and prescription acne treatments. It works primarily by targeting and reducing the presence of Cutibacterium acnes (C. acnes), a type of bacteria that contributes to the formation of acne. In addition, it helps in exfoliation, exerts an anti-inflammatory effect and reduces resistance if antibiotics are prescribed.

Although benzoyl peroxide is a common acne formulation found over the counter, it is associated with skin irritation and can cause bleaching of clothing.

Retinoids such a tretinoin, adapalene and trifarotene (a 4th generation retinoid) reduces inflammation and comedome formation. This helps to treat, prevent and reduces acne scarring. Retinoids are a cornerstone treatment and prevention of your acne and acne scars.

Antibiotics works by reducing inflammation and bacteria in your pores. They are now combined with benzoyl peroxide to reduce the risk of resistance.

Azelaic acid works by reducing inflammation and is effective at reducing post-inflammatory hyperpigmentation. It is considered safe to use while in pregnancy.

Oral hormonal acne treatment

Antibiotics such as doxycycline, tetracycline and minocycline help to reduced inflammation and bacteria inside the pores. They are often combined with other treatments for their synergistic effects.

Oral contraceptive pills help by reducing androgens. This reduces inflammatory and comedomal acne. However, the risk of blood clots may render this treatment unsuitable for some individuals.

Spironolactone helps by reducing androgen activity and thereby acne formation. A combination with topical therapy shows better results.

Isotretinoin is an oral retinoid for severe acne, acne not responding to standard treatments or nodulo-cystic acne. It works by reducing sebaceous gland activity and inflammation. Pregnancy during isotretinoin therapy is a strict contraindication.

Laser treatment

advatx laser treatment

The FDA-approved ADVATx laser uses  2 unique wavelengths to treat active acne and acne scars. It involves using specific wavelengths of light to target and reduce acne-causing bacteria, inflammation, and oil production in the skin. Lasers can also help improve the appearance of acne scars by promoting collagen production and skin regeneration. The advantage of this system includes the treatment of:

  • Active inflammatory acne
  • Atrophic acne scars
  • Post-acne redness or post-inflammatory erythema
  • Improved skin tone and texture

Frequently Asked Questions About Hormonal Acne

Hormonal acne tends to be deeper and more cystic than other types of acne. It typically appears in specific areas of the face, such as the lower face, jawline, and neck, and often coincides with hormonal fluctuations during puberty, menstruation, pregnancy, or hormonal therapy.

Yes, certain lifestyle changes can help manage hormonal acne. These may include maintaining a healthy diet, managing stress levels, getting enough sleep, avoiding harsh skincare products, and practicing good hygiene habits.

The timeframe for seeing results from hormonal acne treatments varies depending on the severity of the acne and the chosen treatment method. Some people may notice improvements within a few weeks, while others may require several months of consistent treatment before seeing significant results.

While hormonal acne cannot always be completely prevented, certain measures may help reduce the risk of breakouts. These include maintaining a healthy lifestyle, managing stress, practicing good skincare habits, and seeking early treatment for hormonal imbalances or acne flare-ups.

No, hormonal acne can affect individuals of any age, although it is most common during puberty and adolescence due to hormonal fluctuations. Hormonal acne may also occur in adults, particularly women, during menstruation, pregnancy, menopause, or when using hormonal medications.

If hormonal acne is persistent, severe, or causing emotional distress, it’s advisable to seek guidance from a dermatologist or healthcare provider. They can evaluate the acne, recommend appropriate treatments, and address any underlying hormonal imbalances or medical conditions contributing to the acne.

Dr Moses Ng dermatologist

Hormonal acne

Hormonal acne is a multifactorial condition requiring a personalized treatment approach. By combining effective therapies with topical treatments and lifestyle modifications, we can achieve significant improvements in skin clarity and patient quality of life. My goal is to provide holistic and patient-centered care, ensuring optimal treatment outcomes through evidence-based practices and individualized care plans.

Schedule a consultation for hormonal acne treatment in Singapore

We treat a range of acne and acne scars at both our clinics in Woodlands and Kovan. Contact us today to schedule a consultation, so that Dr. Ng can develop a personalized treatment approach for resolving your skin concerns and helping you to achieve long-term improvements in the health and appearance of your skin.

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  2. Fisk WA, Lev-Tov HA, Sivamani RK. Epidemiology and management of acne in adult women. Curr Derm Rep. 2014;3:29-39.
  3. Sardana K, Bansal P, Sharma LK, Garga UC, Vats G. A study comparing the clinical and hormonal profile of late onset and persistent acne in adult females. International journal of dermatology. 2020 Apr;59(4):428-33.
  4. Layton AM, Eady EA, Whitehouse H, Del Rosso JQ, Fedorowicz Z, van Zuuren EJ. Oral spironolactone for acne vulgaris in adult females: a hybrid systematic review. American journal of clinical dermatology. 2017 Apr;18:169-91.
  5. Santer M, Lawrence M, Renz S, Eminton Z, Stuart B, Sach TH, Pyne S, Ridd MJ, Francis N, Soulsby I, Thomas K. Effectiveness of spironolactone for women with acne vulgaris (SAFA) in England and Wales: pragmatic, multicentre, phase 3, double blind, randomised controlled trial. bmj. 2023 May 16;381.